0 


HX64124185 
RC311  .C23  Directions  lor  livin 


RECAP 


Thomas   Spees   Carrington 


Directions  for   livin?;  and   sleepinf;  in 
the   open  air. 


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http://www.archive.org/details/directionsforlivOOcarr 


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DIRECTIONS 

FOR 

LIVING  AND  SLEEPING 

IN  THE 

OPEN  AIR 


THE  NATIONAL  ASSOCIATION 

FOR  THE  STUDY  AND  PREVENTION  OF  TUBERCULOSIS 

105  EAST  TWENTY-SECOND  STREET,  NEW  YORK 

1910 


J 


DIRECTIONS 

FOR 

LIVING  AND  SLEEPING 

IN  THE 

OPEN  AIR 

By  THOMAS  SPEES  CARRINGTON,  M.  D. 

Assistant  Secretary  of  the  National  Association  for  the  Study  and  Prevention 

of  Tuberculosis,  in   charge   of  its   Bureau   of  Construction,  and 

appointed  Expert  on   Hospital  Construction  in  the 

New  York  State  Department  of  Health 


ic 


-i  I ' 


A  lean-to  tent  shelter  on  the  roof  of  an  apartment  house  in  New  York  City. 
Arranged  by  Mr.  Frederick  D.  Greene. 


DIRECTIONS  FOR  LIVING  AND 
SLEEPING  IN  THE  OPEN  AIR 

THOMAS  SPEES  CARRINGTON.   M.  D. 

Assistant  Secretary  of  the  National  Association  for  the  Study  and  Prevention 

of  Tuberculosis,  in  charge  of  its  Bureau  of  Construction,  and 

appointed   Expert  on  Hospital    Construction  in  the 

New  York  State  Department  of  Health. 


INTRODUCTION. 

Consumption,  or  tuberculosis,  is  a  disease  of  the  lungs 
which  is  taken  from  others  and  is  not  simply  due  to  catch- 
ing cold.  It  is  generally  caused  by  germs,  known  as  tubercle 
bacilli,  which  enter  the  body  with  the  air  breathed.  The 
matter  w^hich  consumptives  cough  or  spit  up  usually  con- 
tains these  germs  in  great  numbers,  and  if  those  who  have 
the  disease  spit  upon  the  floor,  walls  or  elsewhere,  the  matter 
will  dry,  become  powdered,  and  any  draught  or  wind  will 
distribute  the  germs  in  it  with  the  dust  in  the  air.  Any 
person  may  catch  the  disease  by  taking  in  with  the  air  he 
breathes  the  germs  spread  about  in  this  manner.  He  may 
also  contract  the  disease  by  taking  into  his  system  the 
germs  contained  in  the  small  drops  of  saliva  expelled  by  a 
consumptive  when  coughing  or  sneezing.  It  should  be 
known  that  it  is  not  dangerous  to  live  with  a  consumptive 
if  the  matter  coughed  up  by  him  is  properly  disposed  of. 

Consumption  may  be  cured  at  home  in  many  instances 
if  it  is  recognized  early  and  proper  means  are  taken  for  its 
treatment.  When  a  member  of  a  family  is  found  to  have 
consumption  and  cannot  be  sent  to  a  sanatorium,  arrange- 
ments for  taking  the  cure  at  home  should  be  made  as  soon 
as  the  disease  is  discovered. 

The  following  directions  are  published  to  help  persons 
to  carry  out  the  open-air  treatment  in  their  own  homes. 
Many  families  are  unable  to  make  any  great  change  in  their 
mode  of  living  and  cannot  afford  to  fit  up  porches  and  buy 
extra  bedding  or  warmer  clothing  A  number  of  the  sugges- 
tions given  here  arc  very  simple   and    inexpensive,  and    will 


Tent  shelter  on  a  tenement  house  roof,  partially  protected  from  the  wind  by 

the  stairway  cover  and  nearby  buildings.     Work  of  the 

Bellevue  Hospital  Tuberculosis  Clinic. 


A  bed  on  the  roof  of  a  court  of  a  tenement  house,  protected  on  the  sides  from 

the  wind  by  the  walls  of  upper  stories.     "Work  of  the  New  York 

Association  for  Improving  the  Condition  of  the  Poor. 

4 


help  those  who  would  like  to  use  w^hat  they  have  at  hand  in 
making  an  outfit  for  outdoor  life. 

IT  IS  IMPORTANT,  IN  THE  TREATMENT  OF 
TUBERCULOSIS,  TO  BREATHE  AIR  THAT  IS 
FRESH  AND  PURE,  TO  EAT  AN  ABUNDANCE 
OF  GOOD  FOOD,  TO  STOP  HEAVY  WORK  AND 
WORRY,  AND  TO  TAKE  A  BODILY  AND  MENTAL 
REST  BY  LYING  DOWN  BEFORE  AND  AFTER 
THE  NOON  AND  EVENING  MEALS.  To  obtain  the 
first,  the  patient  must  live  out  of  doors.  This  means  that 
as  many  hours  of  the  day  and  night  as  possible  should 
be  spent  in  the  open  air,  and  in  order  to  carry  out  this 
treatment  some  place  must  be  provided  which  is  not  only 
protected  from  wind,  but  also  from  rain  and  snow,  as 
nothing  except  the  most  severe  cold  weather  should  pre- 
vent the  patient  from  living  and  sleeping  there.  The  out- 
door shelter  should  be  large  enough  for  a  bed,  a  reclining- 
chair  and  a  table.  It  should  overlook  pleasant  and  sanitary 
surroundings  if  possible,  as  it  is  to  be  the  home  of  the 
patient  for  months,  and  will  give  better  results  if  comforta- 
ble and  attractive. 

HOW  TO  TAKE  THE  OPEN-AIR  TREATMENT 
IN    A  TENEMENT   HOUSE. 

Tenement  house  dwellers  and  persons  living  in  apart- 
ment houses  in  large  cities  should  make  every  effort  possible 
to  give  the  open-air  treatment  to  a  member  of  the  family 
who  contracts  tuberculosis.  First,  consider  the  possibility 
of  moving  into  the  suburbs  or  nearby  small  towns.  If  this 
cannot  be  done,  try  to  obtain  from  the  landlord  the  use  of 
the  roof,  and  build  a  small  shack  there  as  described  on 
page  7  of  this  pamphlet.  If  this  is  beyond  the  means  of  the 
family,  use  one  room  with  a  window  opening  on  a  street  or 
large  court  for  the  patient,  and  then  place  the  head  of  the 
bed  beside  the  window  and  cover  it  with  a  window  tent. 
The  cost  of  a  window  tent  is  about  $10.00,  and  if  it  cannot 
be  obtained,  take  two  large,  heavy  cotton  sheets,  sew  them 
together  along  the  edge,  tack  one  end  of  the  double  sheet  to 
the  top  of  the  window  casing  and  drop  the  lower  end  over 
the  outer  side  of  the  bed,  fastening  the  bottom  of  the  sheet 
to  the  bedrail  with  tape.  There  will  be  enough  cloth  hang- 
ing on  each  side  of  the  window  to  form  the  sides  of  the  tent, 
and  these  should  be  fastened  to  the  window  casings.  A 
window  tent  can  be  made  at  home  for  about  $3.00  by  using 


Dr.  S.  A.  Knopf's  window  tent  raised  when  not  in  use. 


Dr.  S.  A.  Knopf's  window  tent  in  position,  with  patient  in  bed  looking  through 

the  celluloid  window  into  the  room,  but  breathing 

outdoor  air  only. 


12  or  15  yards  of  heavy  denim  or  light  canvas.  One  straight 
piece  of  denim  should  be  hung  from  the  top  of  the  window 
casingto  the  outer  side  of  the  bed,  and  the  openings  between 
this  and  the  side  window  casings  filled  in  with  sides  cut 
and  fitted  from  the  balance  of  the  cloth.  By  these  methods 
the  patient  gets  fresh  air  from  the  window  and  the  room  is 
kept  warm  in  cold  weather  as  a  place  for  dressing  and  toilet 
purposes.  During  mild  and  w^arm  w^eather,  the  tent  can  be 
removed  and  the  window  kept  open  both  at  top  and  bottom. 
The  flat  roofs  of  tenement  and  apartment  houses  in  large 
cities  should,  if  possible,  be  used  as  a  breathing  place  by  the 
tenants.  Shacks  or  cabins  can  be  built  upon  them  at  small 
cost  and  make  an  economical  and  easily  provided  shelter. 

HOW  TO  BUILD  A  SMALL  SHACK  OR  CABIN 
ON  A  FLAT  ROOF  IN  THE  CITY. 
Two  by  four  timbers  should  be  used  for  the  frame  and 
siding  boards  for  the  back  and  sides.  The  front  of  the  shack 
should  face  slightly  to  the  east  of  south  and  be  left  open, 
but  arranged  with  a  canvas  curtain,  tacked  on  a  roller  so 
that  it  can  be  closed  in  stormy  weather.  The  shack  can  be 
built  cheaply  with  rough  boards  and  the  roof  covered  with 
tar  paper  or  other  roofing.  As  the  vast  extent  of  flat  roof 
space  in  all  cities  and  in  many  towns  should  be  used  for 
outdoor  living  and  sleeping,  detailed  plans  for  building  a 
shelter  on  them   and  a  list  of  material,  together  with  the 


A  simple  wooden  sliaek  for  a  family  of  three  which  can  be  constructed  on  the 

roof  of  a  tenement  house  or  in  a  yard.     Planned  by  Dr.  H.  E. 

Kirschner  for  the  Oil  City.  Pa.,  Sanatorium. 

7 


approximate  cost,  are  given.  The  plans  and  list  will  be 
understood  by  any  carpenter,  and  when  the  shelter  must  be 
built  economically  it  is  advisable  to  confer  with  the  neigh- 
berhood  carpenter,  rather  than  place  the  construction  in  the 
hands  of  a  contractor  or  builder. 


Front  view,  Floor  plan  and  Elevations  of  a  shack  for  flat  roofs,  to  go  with 
list  of  lumber  below.     Loaned  by  Mr.  W.  H.  Scopes. 

LIST    OF    MATERIAL    AND    ESTIMATE    OF    COST 

FOR  CONSTRUCTING  A  SMALL  OPEN-AIR 

SLEEPING  SHACK  ON  A  CITY   ROOF 

OR  IN   A  COUNTRY  YARD. 


328  feet  of  rough  lumber  as  follows,  at  $30.00  per  M    . 

4  pieces,  2  inches  by  4  inches  by  12  feet,  sills. 

5  pieces,  2  inches  by  4  inches  by  12  feet,  floor  joists. 
14  pieces,  2  inches  by  3  inches  by  14  feet,  studs. 

5  pieces,  2  inches  by  3  inches  by  12  feet,  plate. 


$9.84 


I  piece,  2  inches  by  6  inches  by  12  feet,  plate    front . 
1  piece,    2  inches  by  8  inches  by  12  feet,  rail  for  sliding 

sash. 
9  pieces,  2  inches  by  4  inches  by  14  feet,  rafters  and 

rafter  tails  for  front  eaves. 
300  feet  of  novelty  siding  for  walls  at  $30.00  per  M       $g.oo 

250  feet  of  shiplap  roof  boards  at  $26  00  per  M  .     .     .     .  6.50 

200  feet  of  7-8  inch  common  flooring  at  $32.00  per  M     .  6.40 
One-half  roll  Neponset  Red  Rope  Roofing  at  $5.00 

per  roll 2.50 

10  pieces  of  I -inch  half  round  for  roofing  at  i  cent 

per  foot 1.40 

I  canvas  curtain  on  roll 5.00 

4  sliding  sash,  3  feet  by  3  feet,  at  $2.00 8.00 

I  casement  sash  and  frame,  2  feet  by  2  feet,  at  $2.00     .  2.00 

Hardware       i.oo 

Strips  for  sliding  sash i.oo 

Paint 5.00 

$61.64 
Labor 25.00 

$86.64 
NOTE.      Canvas  can  be  bought  by  the  yard  and  a  curtain  made  at  home. 


A  tcniporarN   pnrch  with  i^la 


a^ti   pr'Ucctinii. 


tenement  hou^c.      Loaned  h\   the  .lournal  of  the  Outdoor  Lite 


^ 


A  window  tent  seen  from  outside.     The  flat  and  extension  roofs  of  the  next 
house  are  good  sites  for  a  shacl<  or  tent. 


Two  sleeping-porches,  one  built  over  the  roof  of  a  back  extension  and  the 

other  built  in  a  corner  of  the  house. 

10 


HOW  TO  ARRANGE  A   PORCH   ON   A   HOUSE 
IN   THE  COUNTRY. 

If  the  family  lives  in  a  small  town  or  in  the  country,  it 
will  usually  be  found  that  a  porch  is  the  most  convenient 
way  of  providing  open-air  quarters.  In  selecting  a  site  for 
the  porch,  it  is  well  to  remember  that  the  patient  should  be 
placed  out  of  doors  in  such  a  way  that  the  cure  can  be  taken 
with  comfort  at  all  seasons  of  the  year.  For  the  winter 
months  the  best  place  is  on  the  south  side  of  the  house,  as 
there  will  be  found  the  greatest  amount  of  sunshine.  If  this 
cannot  be  done,  choose  first  the  east,  or  second  the  west 
side,  but  not  the  north  side  except  as  a  last  resort,  for  it  is  a 
windy  and  cold  position  in  winter.  The  back  of  the  house 
is  usually  better  than  the  front  if  the  porch  cannot  be  seen 
from  the  street,  but  what  is  of  the  most  importance  is  to 
FIND  A  SHELTERED  SPOT  PROTECTED  FROM 
THE  WIND,  FOR  THE  WIND  IS  MUCH  HARDER  TO 
BEAR  THAN  EVEN  INTENSE  COLD.  When  a  house 
has  permanent  verandas  and  the  family  cannot  afford  the 
expense  of  providing  a  special  porch  for  the  patient,  the 
permanent  veranda  on  any  floor  may  be  used  and  privacy 
and  protection  obtained  by  putting  up  canvas  curtains  or 
bamboo  screens. 

If  a  special  porch  for  winter  use  is  to  be  built,  place  it 
on  the  south  side  of  the  second  story  of  the  house,  with  an 
entrance  into  a  room  which  can  be  used  by  the  patient. 
For  a  passageway  to  the  porch  cut  one  of  the  windows 
down  to  the  floor  and  put  in  a  door  3  feet  8  inches  wide,  so 
that  the  bed  can  be  rolled  from  the  room  to  the  porch  with- 
out difficulty.  If  the  room  is  not  heated  by  some  other 
means,  a  stove  should  be  used  and  the  air  kept  warm,  so 
that  the  patient  may  have  a  comfortable  place  for  dressing, 
eating  and  to  enter  when  chilled.  Build  the  porch  out 
from  the  door  10  feet  wide  by  10  feet  long  and  7  feet  or  more 
in  height  from  floor  to  ceiling.  Place  glass  and  sash  on  the 
side  of  the  porch  most  exposed  to  the  weather,  and  hang 
canvas  curtains  on  rollers  to  enclose  the  open  sides  in 
stormy  weather.  Lay  the  floor  with  narrow  spruce  boards, 
using  white  lead  and  oil  to  fill  in  the  cracks,  at  a  grade  of 
I    inch    to    5     feet,   so   that    water    will    not     stand     during 

1 1 


A  well-constructed  porch  with  screens  and  awning  protection,  built  on  the 

roof  of  a  first-floor  veranda.     Loaned  by  the  State 

Charities  Aid  Association,  New  York. 


Showing  a  simple  method  of  using  the  front  veranda  of  a  country  house  by 

protecting  the  sleeping  quarters  with  canvas  curtains.     Loaned  by 

the  State  Charities  Aid  Association,  New  York. 


12 


stormy  weather.  A  porch  of  this  kind  can  be  built  in  small 
towns  and  in  the  country  for  from  $50.00  to  $100.00,  the  cost 
depending  upon  the  class  of  material  used  and  the  way  the 
porch  is  finished. 


HOW  TO   BUILD  A  CHEAP   PORCH. 

A  useful  porch  can  be  built  for  $12.00  or  $15.00  with 
cheap  or  second-hand  lumber,  and  if  only  large  enough  to 
receive  the  bed  and  a  chair  will  still  be  effective  for  the  out- 
door treatment.  The  roof  can  be  made  with  a  canvas 
curtain  or  a  few  boards  and  some  tar  paper.  The  end  most 
exposed  to  the  wind  and  rain  and  the  sides  below  the  railing 
should  be  tightly  boarded  to  prevent  draughts.  A  window 
can  be  used  for  the  approach,  but  it  will  be  more  convenient 
if  it  is  cut  down  to  the  floor  and  a  small  Dutch  door  put  in 
below  the  window-sash.  Second-  and  third-story  porches 
are  supported  from  the  ground  by  long  4  by  4  posts,  or, 
when  small,  they  can  be  held  by  braces  set  at  an  angle  from 
the  side  of  the  house. 


A  cheap  temporary  porch  protected  by  an  awniiii^  and  supported  bv  braces 

set  at  an  angle. 


A  good  method  of  building  a  porch  on  the  back  of  a  cottage  for  country  use. 
Loaned  by  the  Journal  of  the  Outdoor  Life. 


A  cheap  porch  protected  by  awnings,  built  on  the  roof  of  a  first-story  veranda. 

14 


HOW  TO   PROVIDE  A  SHELTER   FOR  THE 
SUMMER  AND   FOR   HOT  COUNTRIES. 

Consumptives  need  a  good  shelter  in  tropical  countries 
and  protection  during  the  summer  months  in  northern 
climates.  A  porch  should  be  placed  on  the  side  of  the 
house  where  the  direct  rays  of  the  sun  will  not  strike 
it  during  the  middle  of  the  day,  and  tents  or  shacks  placed 
under  shade-trees  or  in  the  shadow^  of  large  buildings. 

Awnings  which  jut  out  from  the  roof  of  a  porch  or 
shack  are  used  for  shade,  and  Japanese  drop  curtains  made 
of  long  strips  of  bamboo  for  privacy,  as  they  do  not  stop 
the  current  of  air. 

In  places  w^here  the  streets  are  not  watered,  a  hose 
should  be  used  to  lay  the  dust  in  front  of  the  house,  and  the 
floor  of  the  porch  or  shack  sprinkled  once  or  tw^ice  each 
day  to  cool  the  surrounding  air. 

The  open  sides  of  the  shelter  must  be  screened  from 
the  floor  to  the  roof  with  wire  netting  as  a  protection  from 
flies  and  mosquitoes,  and  when  this  is  impossible,  a  mos- 
quito-bar made  of  cheese-cloth,  netting  or  scrim  should  be 
hung  from  the  roof  or  laid  over  barrel-hoops  attached  to 
the  head  and  foot  of  the  bedstead. 


Showing  a  cheap  method  of  protcoimu  i  slcepinn  porch  in  hot  weather  with 

W-nctian  blinds.      Loaned  by  the  .1.  Ci.  NX'iKon 

.Mff".  Co.,  New  York. 

IS 


A  good  method  of  supporting  a  tent  by  a  frame,  sliowing  the  well-built  floor 
and  ventilator  in  the  peak.     Used  at  the  Otisville  Sanatorium,  N.  Y. 


This  is  a  good  way  to  arrange  a  netting  as  a  protection  from  insects. 
the  barrel-hoops  tied  to  the  bedstead.     Loaned  by  the 
Journal  of  the  Outdoor  Life. 


Notice 


16 


TENTS  AND  TENT   HOUSES. 

Tents  and  tent  houses  can  be  used  as  a  shelter  in 
warm,  dry  climates  and  for  the  summer  months  in  northern 
countries,  but  they  are  not  very  satisfactory  for  winter  use 
in  cold  climates. 

In  order  to  make  a  tent  comfortable  for  a  sick  person,  it 
should  have  a  large  fly  or  double  roof  with  an  air  space 
between,  a  wide  awning  in  front  where  the  patient  can  sit 
during  the  day,  a  board  floor  laid  a  few  inches  above  the 
ground  and  the  sides  boarded  up  two  or  three  feet  from  the 
floor. 

THE  BED  AND  BEDDING  USED  IN 
OUTDOOR  SLEEPING. 
An  ordinary  iron  bedstead  with  woven  wire  spring  3 
feet  6  inches  wide  and  a  moderately  thick  mattress  are  all 
that  are  necessary  except  for  very  cold  weather.  A  bedstead 
which  can  be  rolled  about  easily  is  a  great  convenience, 
and  should  therefore  be  fitted  with  small  rubber-tired 
wheels  or  casters.  A  good  hair  mattress  is  most  desirable, 
but  when  it  cannot  be  obtained,  a  cotton-felt  mattress  can 
be  bought  for  as  low  as  $4.00,  or  a  wool  mattress  for  about 
$10.00,  In  northern  climates,  where  cold  weather  must  be 
expected,  two  mattresses  with  several  layers  of  newspaper 


An  Emmanuel  (  luirch  class  paiiLiit  takinK  the  open-air  treatnient   in   a  back 
yard  of  a  Boston  tenement. 

17 


How  to  make  a  sleeping-bag  with  the  bed-clothes.       First  tuck  all   covers 

except  the  top  blanket  under  the  bed-pad,  and  then  tuck  the  top 

blanket  under  the  mattress.     Loaned  by  the 

Journal  of  the  Outdoor  Life. 

between  them  are  often  used.  Over  the  mattress  place  an 
old  blanket  or  a  cotton  bed-pad,  the  same  width  as  the  mat- 
tress, and  on  this  the  ordinary  bed-sheets  or  blanket-sheets. 

BED  COVERS  USED  IN  OUTDOOR  SLEEPING. 
Persons  who  like  heavy  bed  covering  may  use  blankets, 
placing  as  many  layers  over  the  bed  as  desired  for  warmth. 
Those  who  cannot  stand  heavy  covering  can  use  down 
comforts,  as  they  are  very  warm  but  light.  If  these  are  too 
expensive,  lamb's-w^ool  or  cotton-filled  comforts  can  be 
bought,  or  the  material   for  wool   or   cotton  quilts   can   be 

18 


obtained  for  about  $2.00  and  warm,  satisfactory  covering 
made  in  the  home.  Very  cheap,  light,  but  warm  covering 
can  be  made  by  using  paper  blankets  placed  between  two 
thicknesses  of  outing  flannel  or  bed  covers.  These  paper 
blankets  are  sold  for  50  cents  each  and  wear  for  about  six 
months.  A  woolen  horse  blanket  with  an  outside  of  canvas 
can  be  used  as  a  covering  to  protect  the  bedding  in  wet  and 
stormy  weather. 

SLEEPING-BAGS. 
In  very  severe  weather  a  sleeping-bag  may  be  used  for 
patients  who  are  very  susceptible  to  the  cold.  These  bags 
can  be  bought  at  department  stores  for  $15.00  upward, or 
can  be  made  at  home  by  sewing  blankets  together  around 
the  edges,  leaving  the  top  open.  In  making  a  bag,  use  as 
many  layers  as  may  be  desired,  but  place  the  same  number 
of  thicknesses  on  both  sides  of  the  bag.  The  blankets 
should  be  7  feet  long  by  4  feet  wide. 

ARRANGEMENT  OF  PILLOWS  IN 
OUTDOOR  SLEEPING. 
Two  pillows  should  be  used  in  preparing  the  bed  before 
retiring.  Place  them  in  the  form  of  an  inverted  V,  with  the 
apex  at  the  top  of  the  bed  and  the  head  at  the  point  where 
the  two  pillows  meet.  This  position  allows  the  shoulders 
to  nestle  between  the  pillows  and  protects  them  from  the 
cold  wind  which  will  otherwise  find  its  way  under  the  bed- 
clothes when  the  patient  lies  on  his  side  or  turns  over. 

HOW  TO   PREPARE  THE   PATIENT 
FOR  THE   NIGHT. 

In  cold  weather  the  outdoor  sleeper  should  get  into  the 
bed  in  a  warm  room  and  have  some  one  roll  him  out  of 
doors.  When  this  cannot  be  done,  use  a  warm  dressing- 
gown  in  going  back  and  forth  from  the  dressing-room  to 
the  porch,  and  warm  the  bed  by  placing  in  it  for  a  few 
minutes  before  retiring,  a  hot-water  bag,  hot  bncks,  soap- 
stones  or  bottles  filled  with  hot  water.  In  some  instances 
it  is  well  to  leave  a  hot  stone  or  bottle  wrapped  in  flannel 
at  one  corner  of  the  bed.  where  it  will  throw  ofi"  heat  slowly 
during  the  night. 

In  tucking  in  the  patient  at  night,  all  covers  except  the 
top  blanket  or  comfort  should  be  tucked  in  under  the  bed- 
pad  which  lies  on  the  mattress.  The  topmost  cover  is  then 
tucked   under  the    mattress  to  keep  the  under  covers  from 

I  ' 


A  method  of  screening  beds  in  hot  countries.     Loaned  by  the  Journal  of  the 

Outdoor  Life. 

sliding  off  when  the  sleeper  is  restless.  This  method  of 
tucking-in  forms  a  sort  of  sleeping-bag  with  the  bed-clothes, 
known  as  the  Klondyke  bed,  and  prevents  the  cold  air  from 
reaching  the  body. 

CLOTHING  WORN  AT  NIGHT. 
The  night  clothes  worn  by  the  outdoor  sleeper  during 
the  winter  depends  largely  upon  the  strength  of  the  patient. 
Some  persons  need  much  more  than  others,  but  even  the 
weakest  can  usually  keep  warm  if  they  have  blanket-sheets 
and  hot  bottles.  A  woolen  undershirt,  a  sweater  and  a 
long  outing  flannel  nightgown  or  bathrobe  are  usually  worn, 
but  in  very  cold    weather   some  patients    wear    a    pair   of 


A  knitted  helmet  for  protecting  the  head,  neck  and  shoulders.     Loaned  by  the 
Journal  of  the  Outdoor  Life. 

20 


drawers    made   of  flannel,   a   pair   of  bed-socks  or    knitted 
slippers  and  a  woolen  abdominal  bandage. 

HO^A^TO  PROTECT  THE  HEAD   FROM  DRAUGHTS. 

The  head  of  the  bed  should  be  shielded  from  the  wind 
or  a  strong  draught  by  placing  it  close  to  the  protected  end 
of  the  porch,  or  by  covering  it  with  a  canvas  hood  supported 
on  a  barrel-hoop  attached  to  the  bedstead  or  hung  by  a  rope 
from  the  ceiling.  The  patient  can  wear  a  knitted  skull-cap 
long  enough  to  be  pulled  down  to  the  end  of  the  nose  and 
over  the  ears,  or  a  knitted  helmet  which  covers  the  whole 
of  the  head,  face  and  neck,  with  the  exception  of  a  small 
opening  for  the  nose  and  mouth.  A  hood  shaped  like  an 
old-fashioned  sunbonnet  is  very  comfortable,  and  can  be 
made  at  home  from  eiderdown  or  outing  flannel  by  using 
as  many  thicknesses  as  may  be  needed.  NEVER  COVER 
THE  HEAD  WITH  THE  BED-CLOTHES.  If  the  nose 
grows  cold,  use  a  small  piece  of  flannel,  held  by  elastic 
bands  from  the  ears,  to  cover  the  top,  or  a  piece  of  cotton 
held  in  place  by  a  strip  of  adhesive  plaster.  Care  should 
be  taken  not  to  interfere  with  the  inhaling  of  fresh  air  or  to 
allow  the  breath  as  it  is  expelled  from  the  nose  or  mouth 
to  come  in  contact  with  the  cloth  and  form  icicles.  Chap- 
ping of  the  face  during  the  night  can  be  prevented  by  using 
cold  cream  or  vaseline  about  the  nose  and  lips. 

CLOTHING  FOR  DAY  USE. 
The  clothing  for  use  during  the  day  when  the  patient 
is  up  or  sitting  in  a  reclining-chair  should  be  of  light 
weight  but  warm.  Underclothes  of  half  cotton  and  wool 
or  linen  mesh,  and  a  sweater  which  buttons  in  front,  with 
the  ordinary  outer  clothes,  are  usually  worn.  The  over- 
coat for  men,  women  and  children  should  be  of  fur  if  possible, 
as  even  the  cheapest  of  skins  are  warmer  than  any  other 
kind  of  garment.  If  a  new  coat  cannot  be  bought,  a  heavy 
cloth  overcoat  will  give  good  protection,  and  be  much 
warmer  if  it  has  a  high,  soft  collar.  Leather  leggins  and 
woolen  tights  are  used  as  extra  garments,  and  are  a  great 
comfort  when  taking  exercise  on  cold  days. 

HOW  TO   PROTECT  THE   HANDS. 
Patients  who    wish    to   use    their  hands   while    sitting 
out  of  doors    in    cold   weather  can   wear  thin,   well-fitting 
cotton    gloves.     These  are   used   by   army  men,  and  can  bo 


1.  How  to  wrap  a  patient  in  a  chair.     The  reclining-chair  is  first  overlaid  with 

a  rug  or  a  comfortable,  and  double  blankets  extended  their  full  length, 

leaving  the  free  ends  on  the  floor.     Loaned  by  the  Journal 

of  the  Outdoor  Life. 

bought  for  thirty  cents  a  pair.  Over  them  should  be  drawn 
a  knitted  woolen  glove  with  the  ends  of  the  fingers  and 
thumb  cut  off  and  bound  to  prevent  unraveling.  For 
ordinary  protection,  w^hen  not  at  w^ork,  a  heavy  fur  or 
woolen  mitten  should  be  worn  w^ith  long,  w^oolen  w^ristlets. 
Never  use  tight  gloves  of  any  kind  in  cold  weather,  as  they 
restrict  the  circulation  of  the  blood  and  cause  the  hands  to 
grow^  cold. 

HOW  TO  PROTECT  THE  FEET. 
Use  woolen  stockings,  and  if  they  cause  irritation,  wear 
a  cotton  stocking  next  to  the  skin.  Sometimes  tw^o  or  more 
pairs  of  woolen  stockings  are  necessary  in  very  cold 
weather,  but  they  must  alw^ays  be  large  enough  to  fit  loosely. 
Felt  shoes  are  warm  and  light,  and  are  much  used.  Soft 
leather  shoes  covered  by  large  fur-lined  leather  shoes  are 
very  w^arm  and  comfortable,  but  are  expensive,  as  they  must 
be  made  in  a  set,  to  order.  Foot-muffs  should  be  used  in 
sitting  out  during  a  cold  day.  They  are  made  of  fur  or  of 
cotton  quilts  sewed  up  like  a  bag,  into  which  the  feet  can  be 


placed.  On  very  cold  days  the  muff  can  be  placed  in  a 
wooden  soap-box  with  hot  bricks  beside  it,  and  new^spapers 
wrapped  about  the  muff  to  fill  in  the  empty  space. 

CHAIRS  FOR  DAY  USE. 
An  easy-chair  is  a  great  comfort  to  the  patient  during 
the  day.  A  steamer  chair  is  easily  obtained  and  gives  good 
service,  and  the  canvas  chair  with  a  wooden  frame  can  be 
bought  for  $i.oo,  or  the  cane-seat  extension-chair  for  $2.50 
up.  A  more  durable  chair  is  made  for  this  purpose  with  an 
iron  frame,  costing  about  $25.00,  which  can  be  transported 
and  used  in  a  rough  manner  without  danger  of  breakage. 
To  prevent  the  cold  currents  of  air  reaching  the  patient 
from  below,  the  chair  must  be  covered  with  some  thick, 
closely  w^oven,  warm  material.  A  fur  rug  is  the  best  for 
this  purpose,  but  several  layers  of  blankets  and  newspaper 
will  ansv/er  and  are  more  economical. 

TABLE  FOR  WORK  AND  AMUSEMENT  PURPOSES. 
The  patient  should  have  a  table  handy  on  which  to 
keep  books  and  other  things  used  for  amusement  or  work. 
An  adjustable  table,  the  top  of  which  the  patient  can  swing 
before  him  or  away,  is  a  great  convenience,  and  can  be  used 
as  a  book-rest  when  the  hands  are  under  cover. 


2    How  to  wrap  a  patient  in  a  chair.     After  seatinc  yourself,  draw  up  the  free 

ends  of  the  blanket  and  tuck  in  at  the  sides.     A  steamer  rug  is  placed 

over  all.      loaned  by  the  .fournal  of  the  Outdoor  Life. 


GENERAL  DIRECTIONS  FOR  THE  CARE 
OF  THE  PATIENT. 
The    directions    for    the    care    of    the    patient    are    not 
intended   in   any    way   to  take   the   place   of  a   physician's 
orders.     Every  consumptive  should  consult  a  doctor,  and 
these  suggestions  are  given  to  help  the  patient  carry  out 
his  directions.     Rest  is  a  most  important  part  of  the  open- 
air  treatment,  and  exercise  must  be  regulated  by  the  doctor. 
Always  have  at  hand  an  extra  wrap,  and  never  remain  out  if 
chilled.     Cold  weather   should  have  a  bracing   effect,  and 
when  it  does  not,  go  into  a  warm  room  and  get  a  hot  drink, 
preferably  milk,  remaining  indoors  until  com.fortably  warm. 
"When  going  out  again  use  more  wraps,  and  keep  behind  a 
shield  or  screen  that  breaks  the  force  of  the  wind.     Always 
be  cheerful  and  hopeful;  never  waste  your  strength  in  anger 
or  by  being  cross.     Lead  a  temperate  life,  go  to  bed  early 
and  get  up  late;  do  not  use  alcohol  in  any  form  except  when 
prescribed  by  your  doctor.     Do  away  with  tobacco  if  possi- 
ble, and  use  only  weak  tea  and  coffee  in  small  quantities. 
Never  sw^allow^  the  matter  coughed  up,  but  always  destroy 
every  particle  by  spitting  in  a  paper  or  cloth  which  can  be 
burned.     Never   allow   the    hands,  face  or   clothing   to  be 
soiled  by  sputum,  and  if  this   happens   by   accident,  wash 
the   place  soiled  with  soap  and  hot  water.     Men  who  have 
consumption  should  not  wear  a  moustache  or  beard  unless 
it  is  trimmed  close.     Particular  care  must  be  taken,  \vhen 
sneezing  and  coughing,  to  hold  in  the  hands  before  the  face 
a  cloth  which  can  be  burned.     Soiled  bed-clothes,  night- 
dresses,    other    washable    garments    and    personal    linen 
should  be  handled  as  little  as  possible  until  they  are  boiled 
prior   to   their   being    washed.     The    dishes    used    by    the 
patient  must  be  boiled   after  each   meal. 

All  the  above  means  care  and  work,  but  must  be  done 
both  as  a  protection  to  the  household  and  in  order  to  bring 
about  a  speedy  cure  for  the  patient. 


24 


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